TRICARE Prime West Region Referral Waiver Extended

TRICARE Management Activity
(TMA) recently announced the continuation of referral waivers for
TRICARE Prime beneficiaries in the TRICARE West Region. The waiver
period, which was originally slated to end on May 18th, has
been extended through June 18, 2013. The waiver suspends the
requirement that all referrals be approved by United Healthcare before
the beneficiary could obtain specialty care. United is the new
administrator for TRICARE’s West Region and has made progress in
reducing the backlog of referral requests since the initial waiver was
announced. The extension will allow more time to process existing
referrals and ensure beneficiaries are seen by specialists in a timely
manner.

The waiver applies to referrals
obtained from April 1 through June 18, 2013, for care expected to be
received through August 18, 2013. While United Healthcare continues to
clear its backlog of referrals, Prime enrollees in the West Region who
get a referral from their Primary Care Manager (PCM) will still be able
to seek TRICARE-covered services from a network specialist. This
authorization waiver is only for TRICARE Prime beneficiaries in the West
Region.